Unfortunately we can’t be well-rounded enough to be competent to treat ever population and every disorder. The only people who might be able to do that have been in practice 25 to 30 years. If you’re new to private practice, you will want to narrow down who you can work with and who you need to refer.  Learn when to refer clients to other providers.Since I started my practice, I’ve gotten calls from people who want to bring their children to me. I have worked with kids before so I could have justified taking them. I’m actually very good with kids but I know I don’t enjoy it. If it’s in family therapy with the parent present, it doesn’t bother me. But I’d rather not work one-on-one with kids. When I get calls to treat anyone under age 14, I tell the parent that I don’t work with children under age 14.

They are grateful that I am honest with them. I believe this honesty has helped spread good word about my practice in my area. Imagine if you called a therapist and they were honest about their limitations. Wouldn’t you be more willing to trust them? Wouldn’t you be more willing to tell your friends and family about them? I believe the people who call and I refer elsewhere will remember me if they know anyone else who needs a therapist. Perhaps the parent will decide they want therapy later down the road. I might be the first person that comes to mind because of my honesty.

When to Refer

  • Populations you don’t have experience with or haven’t worked with in the last five years or so.
  • Disorders you have no experience with or haven’t worked with in the last five years.
  • People who are interested in a theory you have no experience with. Sometimes people will ask for CBT or another type of therapy they had before.
  • People who want religious therapy in a religion you are unfamiliar with or not an active member of. If someone wants Christian counseling and you haven’t been to church since you were a kid, you may want to refer them to someone who specializes in this.
  • People with special circumstances you are unfamiliar with.

Populations

They are many different populations and we don’t usually have much experience with all of them. Below are some different populations.  Consider whether you are experienced enough to handle them before you take them as clients.

  • Older Adults (65+)
  • Adults
  • Adolescents (14 to 19)
  • Children (6 to 10)
  • Toddlers/preschoolers (0 to 6)

In addition to ages of clients, consider the following section of special populations. One special population to consider is meeting any multicultural needs of the client. Multiculturalism is an important part of therapy. To work with different cultures, you have to have an understanding of their worldview and not try to change them to your own worldview.

Special Populations

  • Male
  • Female
  • Couples
  • Families
  • Single parent
  • Blended families
  • LBGTQ
  • Veterans and military personnel
  • Culture and race (African-American, Asian, Hispanic, Native American, etc.)
  • Religions (Christian, Jewish, Mormon, Muslim, Buddhist, etc.)
  • Students
  • People with disabilities (Blind, hard of hearing, etc.)

Realize that it is alright to refer someone at any time. Even if a client has come to you for months, you may discover issues you were not aware of when you started seeing them. Below are some issues that could come up that you may have to refer to someone else if you don’t have experience with these issues. It doesn’t necessarily mean you have to refer them to another therapist because there are also community resources they may need referred to.

Special Issues

  • Career or employment problems
  • Health problems (Cancer, terminally ill, chronic pain, hepatitis, HIV/AIDS, etc.)
  • Addiction (Drugs, alcohol, gambling, gaming, other process addictions)
  • Family of addict or alcoholic
  • Opioid maintenance (Suboxone or methadone)
  • Emotional, sexual or physical abuse
  • Poverty and basic needs (Need for housing, food, income, underemployment, etc)
  • Criminal involvement (Arrests, pending charges, probation, house arrest or jail)
  • Child Protective Services involvement
  • Child custody issues
  • Grief and loss
  • Loss of a child or parent
  • Suicide survivor
  • Family or friend of someone who committed suicide
  • Self-harm
  • Pedophilia

I think I covered most populations but I’m sure there are probably hundreds of other special issues that I didn’t think of. If you can think of other special populations or issues, please leave a comment and I will add them to the list.